Who benefits if charity leaders lobby for more competition in the NHS?

Charity boss Sir Stephen Bubb lobbied alongside
the head of a private healthcare trade group to persuade Jeremy Hunt to not
water down highly controversial “Section 75” privatisation regulations,
according to new documents revealed today.

The regulations - made under the Health
& Social Care Act just as the bill was coming into force in April this year
- were seen by many as confirming the determination of the government to hand
over large swathes of the NHS to private companies. The regulations effectively
force local health bosses to put all
services out to tender unless they can prove there is just one capable provider.

As the debate raged over the implications
of the regulations - with the RCGP, the RCN, and the BMA all coming out
strongly against them - the Chairman of the Association of Chief Executives of
Voluntary Organisations (ACEVO), Sir Stephen Bubb, teamed up with private
healthcare advocates the NHS Partners Network to lobby the health secretary,
Jeremy Hunt into not "watering down" the regulations.

The letter co-signed by Sir Stephen Bubb
and Partners Network director David Worskett raised "deep concern" at reports
in the Guardian that the government was "contemplating substantive concessions
over these important regulations."

Bubb and Worskett urged the NHS to "embrace
a new culture" to include "opening the way" for the potential contribution of "new providers…We strongly urge the government to stand firm."

Earlier this year Social Investigations exposed how Bubb was
at the heart of a network of lobbying around the Health and
Social Care Act itself, along with Nick Seddon (now Cameron’s health policy advisor). The NHS Partners
Network’s members include private healthcare companies with
multiple financial links to MPs and Lords. These groups were instrumental in
lobbying during the supposed ‘pause’ in the passage of the Health & Social
Care Act last year, following near total discontent across the medical
profession with the Bill’s proposals.

Sir Stephen Bubb was invited by then Health
minister Simon Burns to head the Choice and Competition panel of the NHS Future
Forum. The appointment made sense to the Conservatives as Sir Stephen Bubb had
already been campaigning for a bigger role for the voluntary sector in the
public services, a key part of the Conservative party’s ‘Big Society’ mantra.

Partners Network leader David Worskett praised
Bubb for his determined approach to opening up the NHS to competition,
informing his members of his "lengthy" discussion with Sir Stephen Bubb where they
had "agreed on the approach he would take, what the key issues are, and how to
handle the politics." Bubb had "not deviated from this for a moment throughout
the period."

Stephen Bubb's ability to get the 'agreed'
message across was appreciated by Worskett and was seen to be so supportive
that he "often carried the day and won more support than we might have
expected.”

The charity and voluntary sector make up
over a third of the UK private healthcare sector,
and according to Sir Stephen Bubb represent a ‘bigger player’ than people
think. Bubb told a 2010 voluntary sector conference "The third sector could grow by £2bn a year
by 2015, just through increased involvement in offender rehabilitation and
public health."

Shortly after coming into power the
government met with the CBI to discuss privatisation strategy. Leaked
minutes revealed that Francis Maude told the group that transferring
services at least initially to “charities,
social enterprises and mutuals” would be more “palatable” and carry less
“political risk” than “wholesale outsourcing to the private sector”. However
in reality charities cannot compete against the financial muscle of the private
sector. Research conducted by campaign organisation the NHS Support Foundation
shows that since April 1st this year 100 clinical services worth
£1.5 billion have largely gone to commercial companies. Last
month the Bain Consultancy revealed how private sector companies are now engaged in an ‘arms race’ to win £5bn of
National Health Service contracts. Third sector advocates should learn from the
experience
of Surrey Central Health, where a much lauded transfer of NHS services to a “social
enterprise” led within a couple of years to a takeover by Virgin, who were
better able to raise bond finance.

Recent failings from private companies such
as Serco fiddling data for their out of hours service, or G4S overcharging on
their contracts, has done nothing to diminish the speed with which outsourcing
is taking place. However, as the list of private outsourcing failures grows,
the government will increasingly appreciate being able to emphasise the 3rd
sector as a more palatable alternative, even if their involvement is not
sustainable. In fact, David Cameron has already turned towards the voluntary
sector in his hour of need. When asked by Ed Miliband who supported the
government’s legislation he cited Bubb’s ACEVO.

Does Bubb’s vociferous support for
privatisation benefit the 1,500 ACEVO membership of charity leaders (the
members of whom are currently hidden from public view)? Or does it ultimately
benefit the members of the NHS Partners Network, whose membership includes
Virgin Care, United Health UK or Care UK?

A recent article in the Guardian by Pam
Lewis of CancerCare suggests some charities at least are willing to take part in
the dismantling of the NHS. Ms Lewis states how the changes to the NHS will
benefit CancerCare and at the same time take the strain off of "traditional NHS
care providers." Echoing Bubb, she says that "while
maintaining their charity status", they can become a "serious and competitive
player" in the NHS, which would be a "huge step for their charity."

Despite the grand ambitions of CancerCare,
the evidence so far suggests charities are but a figleaf for the private equity
backed corporations who can outbid them or offer them dubious partnerships. The
carrot is dangled in front of the charities noses, which has led them to walk
hand-in-hand with private healthcare giants.

Andrew Robertson is the founder of the blog Social Investigations and has been a freelance investigative journalist for 20 years, writing in the Independent, Red Pepper and for Indymedia. Follow him on Twitter @socialindepth.

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